ANALYSIS OF THE PROFESSIONAL SATISFACTION OF PHARMACISTS IN BRATISLAVA

A pharmacist is an expert on medications. At the same time as the most accessible health care provider, the pharmacist fulfills an important social mission. For a pharmacist, work satisfaction plays an important role in several aspects of his practice in a pharmacy. Our primary goal was to conduct a local analysis with the purpose of testing the proposed questionnaire evaluating various dimensions of the professional satisfaction of pharmacists. Our secondary goals were as follows: to analyze individual dimensions of pharmacists’ professional satisfaction, to assess the quality of life in the context of the pharmacists’ professional satisfaction and to analyze the impact of selected characteristics (age, location of the pharmacy) on the pharmacists’ quality of life. The study is based on a questionnaire survey among pharmacists in Bratislava from July to September 2016. Data were collected in person. Respondents were randomly selected from community pharmacies., Equal number of respondents were selected from three different types of pharmacies: a) public pharmacy or its branch in a medical facility or a health centre b) public pharmacy or its branch in a shopping centre c) public pharmacy or its branch in a residential housing development. The results of the study show that the professional satisfaction of pharmacists in Bratislava is evaluated positively. Out of all 27 questions of the questionnaire, only three were evaluated negatively. The analysis points out that pharmacists are dissatisfied with the conditions in the workplace, regulation and legal responsibilities stemming from the profession of a pharmacist, healthcare system, and health insurance companies. The majority of the pharmacists characterized their state of mind on the job as concentrated. Older respondents were more tired and less energized. With regards to the location of a pharmacy, respondents that work in pharmacies located in residential housing developments feel the most concentrated. The knowledge of needs and problems of the profession is the essential precondition for its continued successful development, and its position in current as well as future European and Slovak healthcare systems. Until now, the quality of the professional life of pharmacists has not become a subject of systematic research and evaluation in Slovakia. Our study showed that the professional satisfaction of pharmacists in Bratislava is evaluated positively. UDC Classification: 159.96; DOI: http://dx.doi.org/10.12955/cbup.v5.1003


Pharmaceutical care
Slovak Act No. 362/2011 Coll.defines pharmaceutical care as one of the three forms of health care provision, and from the perspective of the Slovak legislation, it covers the providing, preparation, inspection, storage, dispensation of medications with the exception of preparation of transfusion medications and medical aids, mail order dispensation, providing expert advice about medications and medical aids, and consultations with regard to determination and monitoring of the treatment.Pharmaceutical care is provided: 1. in public pharmacies that are set up as educational bases 2. in public pharmacies and branches of public pharmacies 3. in hospital pharmacies 4. in dispensaries of medical aids 5. in dispensaries of orthopedic and prosthetic medical aids.Stanko & Minarovič (2011) state that based on the legislation of definitions and the conception of pharmaceutical care development defined by international authorities in the field of health and pharmacy, basic roles, and functions in the pharmaceutical care system can be categorised according to the character of individual activities into following groups: a) logistics b) dispensation c) consulting d) distribution e) screening and monitoring f) other activities.Professional satisfaction of pharmacists Snopková et al. (2014) argue that since pharmacists play a key role in informing patients about prescribed medications and ensuring suitability of the prescribed treatment, it is important to consider the question of which qualities of a pharmacists' work environment have a connection with the integration of the pharmacotherapeutic monitoring into the daily practice, and what obstacles are present in this process.For a pharmacist, the work satisfaction plays an important role in many aspects of his practice in a public pharmacy.A low level of work satisfaction can have a negative impact on his work performance.Dissatisfaction can also influence the way a pharmacist interacts with patients.Consequently, patients tend to limit their cooperation with a pharmacist.It is important to obtain information about pharmacists' attitudes toward performing their work, and about factors associated with their work attitudes.Given that healthcare workers can suffer from stress, especially due to the 661 long-term effect of negative factors present in the workplace, their work attitudes should be examined.Matthew et al. (2008) describe the positive influence of pharmacists' work satisfaction as follows: 1) A satisfied pharmacist at work will positively impact his community; as a result, fewer work position changes occur 2) Work satisfaction of a pharmacist positively impacts his own mental and physical health.3) A satisfied pharmacist positively impacts the patient and his health.Workload in the pharmaceutical profession McCann et al. (2009) emphasize that pharmacists today need to meet many high (professional, communication) demands.This fact is caused especially by a rising competition in healthcare and the need to improve healthcare services.This change may positively impact patient's satisfaction (Mináriková et al., 2015;Mináriková et al., 2016).This trend has shown to have an influence on the overall prosperity of community pharmacy and both accessibility and availability of pharmaceutical care (Malovecká et al., 2015, Malovecká et al., 2016).However, as a result, pharmacists at work often deal with stress and mental strain.Pelcák & Tomeček (2011) define workload in a pharmacy as a sum of specific situations and activities (breach of the confidentiality zone, communication with problematic types of patients, dealing with complaints) that can be subjectively associated with mental burden.Consequently, cumulative stress can lead to professional failure or personality disintegration.

Methodology
The analysis of pharmacists' professional satisfaction in Bratislava was carried out between July and September 2016.Data collection was realized in person.Respondents were randomly approached in community pharmacies.We aimed at collecting responses from an equal number of respondents from three different types of pharmacies: a) a public pharmacy or its branch in a medical facility or a health center b) a public pharmacy or its branch in a shopping center c) a public pharmacy or its branch in a residential housing development In total, we obtained 25 questionnaires from each type of pharmacy.Overall, 75 respondents from a total number of 23 pharmacies participated in our research.The questionnaire consisted of the following parts: Dimension A: internal environmentaltogether nine questions were allocated here, pertaining to the organization of a pharmacy as a workplace, work hours, and relationships in the workplace.Dimension B: external environment -9 questions were allocated here, pertaining to legislative issues in providing pharmaceutical care, relationships with health insurance companies, professional organizations, and patients.Dimension C: personal satisfaction -5 questions were allocated here, pertaining to personal matters such as financial remuneration, career advancement, etc. Dimension D: quality of life -3 questions were allocated here, pertaining to a subjective assessment of the state of health, quality of life during the last month, and its comparison with the time period of 10 years ago.Satisfaction was evaluated using 26 predetermined questions (Are you satisfied with…) using a 5-point Likert scale (nomore likely noneither yes nor nomore likely yesyes).The results were processed using the Microsoft Excel program and expressed quantitatively (count, percentage).We consolidated the proportions of respondents from the Likert scale into three ranges as follows: 1) no / more likely no, 2) neither yes nor no, 3) more likely yes / yes.

Results
Dimension A was focused on evaluation of the internal environment.Here, pharmacists expressed the highest level of satisfaction (82.66%) with the question concerning superior-subordinate communication.Satisfaction with a work team, the atmosphere in the workplace, communication of tasks, feedback based on work performance, and satisfaction with the support from the direct supervisor were rated highly positively (81.33%).More than half of the respondents (54.66%) were satisfied with the determination of work hours and the length of their work day.In this dimension of questions, respondents were the least satisfied with conditions in the workplace (satisfaction was expressed by only 33.33% of pharmacists).Table 1 displays the results from Dimension A in detail.Dimension B assessed the external environment.Here, most positive aspects were: attitude and respect of patients and pharmacists' readiness for their profession during their studies.Cooperation with physicians and employment opportunities available abroad were also rated highly positively (72.00%).Almost 59% of the pharmacists were satisfied with the opportunities for continuing education and activities of professional and specialized organizations for pharmacists.In contrast, pharmacists expressed a high level of dissatisfaction (77.33%) with the healthcare system, and with the cooperation with health insurance companies.Dissatisfaction with the regulation and legal responsibilities stemming from the pharmaceutical profession was expressed by almost 51% of respondents.Dimension C concerned pharmacists' personal satisfaction.Here, responses were positive to all of the questions.The most positively rated aspect (100.00%) was professional pride.Pharmacists expressed a high level of satisfaction with their work position and job content (78.66%), and relaxed feeling at work (77.33%).Furthermore, 68.00% of pharmacists expressed satisfaction with the acceptance of their proposals and requests in the workplace and 60.00% with their financial remuneration.Table 3 displays the results from Dimension C in detail All aspects within Dimension D evaluating pharmacists' quality of life were rated positively.Pharmacists were most satisfied with their quality of life in the last month (76.00%) and their current overall physical and mental health (74.66%).The question in which pharmacists were asked to compare their current quality of life with their quality of life 10 years ago, was rated positively as well.Table 4 displays the results from Dimension D in detail.

Analysis of the impact of selected characteristics on the pharmacists' quality of life
The results of the analysis show that the majority of pharmacists in each age group described their state of mind on the job as "concentrated" (Table 5, Figure 1).Pharmacists aged 31-45 feel the most "concentrated" (79.31%) on the job, while the least "concentrated" on the job is the youngest group of respondents.Our analysis suggests that there is a correlation between the respondents' age and state of mind while performing their work at a pharmacy: the older the respondents were, the more "tired" and "less energized" they felt.In regard to the pharmacy location, respondents working in pharmacies localized in residential housing developments feel most "concentrated" (76.00%).Pharmacists working in shopping centers feel least "concentrated," while at the same time, they are the most tired of all pharmacists.

Discussion
Increasing demands on professional and communication competencies, rising competition in healthcare, and integration of healthcare services all impact sustainability of a traditional manner of pharmacy development.The emphasis on quality of pharmaceutical care lies above all in the responsibility toward the patient.Nowadays, it is important to give enough space to the satisfaction of professionalspharmacists as well and to look for new opportunities to improve their professional life.A positive evaluation emerged from a study of the American Pharmaceutical Association, regarding the quality of professional life of pharmacists in a pharmacy environment, and focused on issues pertaining to work satisfaction, career advancement, realisation of plans of organizations, and patient care.However, it discovered differences in the quality of professional life related to practice in the area of primary care, This study analyzed the attitudes of pharmacists toward the quality of pharmaceutical care.Their results showed the positive evaluation of pharmaceutical care by the pharmacists.However, the individual healthcare systems of the European Union still do not pay enough attention to the professional satisfaction of pharmacists.Moreover, financial remuneration impacts the quality of pharmaceutical care as well.The study carried out by Mosadeghrad et al., 2008 endorse the fact that financial remuneration could increase the level of professional satisfaction of pharmacists, and thus improve the quality of provided health services.

Conclusion
Patient satisfaction is one of the main indicators of the quality of provided pharmaceutical services.The identification of weak points in the pharmaceutical profession and subsequent targeted solutions open possibilities for increasing professional satisfaction and self-confidence of pharmacists as healthcare workers.The knowledge of needs and problems of the profession is the essential precondition for its continued successful development, and its position in current as well as future European and Slovak healthcare systems.Our primary goal was to carry out a local analysis using a questionnaire evaluating various dimensions of the professional satisfaction of pharmacists.We have analyzed individual dimensions of pharmacists' professional satisfaction, assessed their quality of life in the context of their professional satisfaction and evaluated the impact of selected characteristics (age, location of the pharmacy) on their quality of life.The results of our study suggest that professional satisfaction of pharmacists in Bratislava is evaluated positively.

Figure 1 :
Figure 1: Respondents' state of mind during their work at a pharmacy depending on their age (n = 75)

Figure 2 :
Figure 2: Respondents' state of mind during their work at a pharmacy depending on the location of a pharmacy (n = 75) and gender variables.Urbonas et al., 2010 conducted a study in Lithuania focused on the professional satisfaction of pharmacists.

Table 5 :
Respondents' state of mind during their work at a pharmacy depending on their age (n = 75)

Table 6 :
Respondents' state of mind during their work at a pharmacy depending on the location of a pharmacy (n = 75)